Healthcare Provider Details

I. General information

NPI: 1013022722
Provider Name (Legal Business Name): WILLIAM LIU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 04/16/2021
Certification Date: 04/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 N PROSPECT AVE STE 103
REDONDO BEACH CA
90277-3033
US

IV. Provider business mailing address

520 N PROSPECT AVE STE 103
REDONDO BEACH CA
90277-3033
US

V. Phone/Fax

Practice location:
  • Phone: 310-376-8816
  • Fax: 310-374-2806
Mailing address:
  • Phone: 310-376-8816
  • Fax: 310-374-2806

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberG51849
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: